Abstract
Children with posterior fossa tumors have hydrocephalus in 60–91% of cases. Even though this condition is quite common, optimal treatment algorithm has not yet been determined.
In the past, the majority of children were diagnosed too late and were usually admitted to hospital in poor neurological state. Neurosurgeons agreed that hydrocephalus should be treated immediately with shunting and only after the child is stable and recovered to continue with the tumor resection. Nowadays, endoscopic third ventriculocisternostomy is a widely applied, safe, and efficient procedure.
In high-risk patients or patients in neurologically bad condition, hydrocephalus needs to be addressed primarily before tumor resection. Authors prefer endoscopic third ventriculocisternostomy instead of a shunt, because of its low complications rate and high rate of success in this particular group of patients. Shunting should be reserved for the cases where ETV failed or it’s technically not possible.
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References
Albright L, Reigel DH (1977) Management of hydrocephalus secondary to posterior fossa tumors. J Neurosurg 46(1):52–55. https://doi.org/10.3171/jns.1977.46.1.0052
Bateman GA, Fiorentino M (2016) Childhood hydrocephalus secondary to posterior fossa tumor is both an intra- and extraaxial process. J Neurosurg Pediatr 18(1):21–28. https://doi.org/10.3171/2016.1.PEDS15676
Bhatia R, Tahir M, Chandler CL (2009) The management of hydrocephalus in children with posterior fossa tumours: the role of pre-resectional endoscopic third ventriculostomy. Pediatr Neurosurg 45(3):186–191. https://doi.org/10.1159/000222668
Culley DJ, Berger MS, Shaw D, Geyer R (1994) An analysis of factors determining the need for ventriculoperitoneal shunts after posterior fossa tumor surgery in children. Neurosurgery 34(3):402–407; discussion 407–408. https://doi.org/10.1227/00006123-199403000-00003
Dewan MC, Lim J, Shannon CN, Wellons JC 3rd (2017) The durability of endoscopic third ventriculostomy and ventriculoperitoneal shunts in children with hydrocephalus following posterior fossa tumor resection: a systematic review and time-to-failure analysis. J Neurosurg Pediatr 19(5):578–584. https://doi.org/10.3171/2017.1.PEDS16536
Dias MS, Albright AL (1989) Management of hydrocephalus complicating childhood posterior fossa tumors. Pediatr Neurosci 15(6):283–289; discussion 290. https://doi.org/10.1159/000120484
Due-Tonnessen BJ, Helseth E (2007) Management of hydrocephalus in children with posterior fossa tumors: role of tumor surgery. Pediatr Neurosurg 43(2):92–96. https://doi.org/10.1159/000098379
El-Gaidi MA, El-Nasr AH, Eissa EM (2015) Infratentorial complications following preresection CSF diversion in children with posterior fossa tumors. J Neurosurg Pediatr 15(1):4–11. https://doi.org/10.3171/2014.8.PEDS14146
El-Ghandour NM (2011) Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in the treatment of obstructive hydrocephalus due to posterior fossa tumors in children. Childs Nerv Syst 27(1):117–126. https://doi.org/10.1007/s00381-010-1263-2
Epstein F, Murali R (1978) Pediatric posterior fossa tumors: hazards of the “preoperative” shunt. Neurosurgery 3(3):348–350. https://doi.org/10.1097/00006123-197811000-00003
Foreman P, McClugage S 3rd, Naftel R, Griessenauer CJ, Ditty BJ, Agee BS, Riva-Cambrin J, Wellons J 3rd (2013) Validation and modification of a predictive model of postresection hydrocephalus in pediatric patients with posterior fossa tumors. J Neurosurg Pediatr 12(3): 220–226. https://doi.org/10.3171/2013.5.PEDS1371
Fritsch MJ, Doerner L, Kienke S, Mehdorn HM (2005) Hydrocephalus in children with posterior fossa tumors: role of endoscopic third ventriculostomy. J Neurosurg 103(1 Suppl):40–42. https://doi.org/10.3171/ped.2005.103.1.0040
Gnanalingham KK, Lafuente J, Thompson D, Harkness W, Hayward R (2003) The natural history of ventriculomegaly and tonsillar herniation in children with posterior fossa tumours – an MRI study. Pediatr Neurosurg 39(5):246–253. https://doi.org/10.1159/000072869
Grunert P, Charalampaki P, Hopf N, Filippi R (2003) The role of third ventriculostomy in the management of obstructive hydrocephalus. Minim Invasive Neurosurg 46(1):16–21. https://doi.org/10.1055/s-2003-37957
Güdük M, Özek MM (2015) Hydrocephalus in pediatric patients with posterior fossa tumors. In: Özek MM, Cinalli G, Maixner W, Sainte-Rose C (eds) Posterior fossa tumors in children. Springer International Publishing, Switzerland, pp 229–238. https://doi.org/10.1007/978-3-319-11274-9
Hanak BW, Bonow RH, Harris CA, Browd SR (2017) Cerebrospinal fluid shunting complications in children. Pediatr Neurosurg. https://doi.org/10.1159/000452840
Kumar V, Phipps K, Harkness W, Hayward RD (1996) Ventriculo-peritoneal shunt requirement in children with posterior fossa tumours: an 11-year audit. Br J Neurosurg 10(5):467–470. https://doi.org/10.1080/02688699647096
Lee M, Wisoff JH, Abbott R, Freed D, Epstein FJ (1994) Management of hydrocephalus in children with medulloblastoma: prognostic factors for shunting. Pediatr Neurosurg 20(4):240–247. https://doi.org/10.1159/000120797
Lin CT, Riva-Cambrin JK (2015) Management of posterior fossa tumors and hydrocephalus in children: a review. Childs Nerv Syst 31(10):1781–1789. https://doi.org/10.1007/s00381-015-2781-8
Morelli D, Pirotte B, Lubansu A, Detemmerman D, Aeby A, Fricx C, Berre J, David P, Brotchi J (2005) Persistent hydrocephalus after early surgical management of posterior fossa tumors in children: is routine preoperative endoscopic third ventriculostomy justified? J Neurosurg 103(3 Suppl):247–252. https://doi.org/10.3171/ped.2005.103.3.0247
Ray P, Jallo GI, Kim RY, Kim BS, Wilson S, Kothbauer K, Abbott R (2005) Endoscopic third ventriculostomy for tumor-related hydrocephalus in a pediatric population. Neurosurg Focus 19(6):E8. https://doi.org/10.3171/foc.2005.19.6.9
Riva-Cambrin J, Detsky AS, Lamberti-Pasculli M, Sargent MA, Armstrong D, Moineddin R, Cochrane DD, Drake JM (2009) Predicting postresection hydrocephalus in pediatric patients with posterior fossa tumors. J Neurosurg Pediatr 3(5):378–385. https://doi.org/10.3171/2009.1.PEDS08298
Ruggiero C, Cinalli G, Spennato P, Aliberti F, Cianciulli E, Trischitta V, Maggi G (2004) Endoscopic third ventriculostomy in the treatment of hydrocephalus in posterior fossa tumors in children. Childs Nerv Syst 20(11–12):828–833. https://doi.org/10.1007/s00381-004-0938-y
Sainte-Rose C, Cinalli G, Roux FE, Maixner R, Chumas PD, Mansour M, Carpentier A, Bourgeois M, Zerah M, Pierre-Kahn A, Renier D (2001) Management of hydrocephalus in pediatric patients with posterior fossa tumors: the role of endoscopic third ventriculostomy. J Neurosurg 95(5):791–797. https://doi.org/10.3171/jns.2001.95.5.0791
Santhanam R, Balasubramaniam A, Chandramouli BA (2009) Fatal intratumoral hemorrhage in posterior fossa tumors following ventriculoperitoneal shunt. J Clin Neurosci 16(1):135–137. https://doi.org/10.1016/j.jocn.2008.02.016
Santos de Oliveira R, Barros Juca CE, Valera ET, Machado HR (2008) Hydrocephalus in posterior fossa tumors in children. Are there factors that determine a need for permanent cerebrospinal fluid diversion? Childs Nerv Syst 24(12):1397–1403. https://doi.org/10.1007/s00381-008-0649-x
Schmid UD, Seiler RW (1986) Management of obstructive hydrocephalus secondary to posterior fossa tumors by steroids and subcutaneous ventricular catheter reservoir. J Neurosurg 65(5): 649–653. https://doi.org/10.3171/jns.1986.65.5.0649
Schneider C, Ramaswamy V, Kulkarni AV, Rutka JT, Remke M, Tabori U, Hawkins C, Bouffet E, Taylor MD (2015) Clinical implications of medulloblastoma subgroups: incidence of CSF diversion surgery. J Neurosurg Pediatr 15(3):236–242. https://doi.org/10.3171/2014.9.PEDS14280
Stein BM, Tenner MS, Fraser RA (1972) Hydrocephalus following removal of cerebellar astrocytomas in children. J Neurosurg 36(6):763–768. https://doi.org/10.3171/jns.1972.36.6.0763
Tamburrini G, Pettorini BL, Massimi L, Caldarelli M, Di Rocco C (2008) Endoscopic third ventriculostomy: the best option in the treatment of persistent hydrocephalus after posterior cranial fossa tumour removal? Childs Nerv Syst 24(12):1405–1412. https://doi.org/10.1007/s00381-008-0699-0
Tamburrini G, Frassanito P, Bianchi F, Massimi L, Di Rocco C, Caldarelli M (2015) Closure of endoscopic third ventriculostomy after surgery for posterior cranial fossa tumor: the “snow globe effect”. Br J Neurosurg 29(3):386–389. https://doi.org/10.3109/02688697.2014.987214
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Zivkovic, B., Özek, M.M. (2019). Hydrocephalus in Posterior Fossa Tumors. In: Cinalli, G., Özek, M., Sainte-Rose, C. (eds) Pediatric Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-319-27250-4_11
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DOI: https://doi.org/10.1007/978-3-319-27250-4_11
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